Opinion: With Three Legislative Days Left, South Carolina Senate Plays Doctor, Again


On Thursday, the South Carolina State Senate passed House Bill 4624, a health care ban for transgender minors. While 24 states have previously passed legislation with a similar goal, South Carolina’s version of the bill is the most extreme: not only for minors but for adults on Medicaid; impacting public funding and forcing public schools to “out” students by requiring them to notify parents if a child wishes to be referred to by a different name, pronoun, or dress outside of what is considered to be “gender conforming.” This comes just days after the 4th Circuit ruled that both West Virginia and North Carolina’s bans on trans health care through Medicaid and public funding are unconstitutional. Debate was meant to start on Tuesday after being put to Special Order the week prior, but it did not begin meaningfully until Thursday. That is a huge testament to community advocates' work, calling into their senators and educating them throughout the legislative session, but increasingly turning up the heat last week. 

Changes to the bill made it different from the House's version. Procedurally, that means that on Tuesday, the Senate version of the bill has to go to the House for concurrence, which is when they agree to the bill's changes. One of the major differences in language surrounds the forced-outing provision, as the House Majority Leader urged his body to weaken that language to have less of a direct impact on public school teachers. The House can choose to accept the changes or not. Should the House choose to accept the changes, the bill will move to the Governor's desk. In a final push to kill the bill, advocates are urged to call their representatives to not concur with the language change in this bill. Should that happen, a conference committee would then determine the differences in the language of the two versions of the bill that passed each chamber. 

Every day that this bill has not become law is another day that trans folks in our state can get all of the care that they need. The ability to have stalled and delayed this bill up until May is no small feat. This bill was taken up on the first day of the session, and we have made it to the last legislative week of the session without this bill becoming law. The organizations pushing the passage of H4624 are either national groups, who shop legislative language around our nation, or statewide groups getting national funding to support their efforts. Meanwhile, those opposing this bill are true grassroots groups, using every resource at their disposal and speaking personally about the implications this bill would have on their lives. Pushing off the passage of this bill has been a true David and Goliath battle, as South Carolina and Virginia are the only states in the region to have not passed a ban on transgender health care. 

However, I know that praise does not make this news any easier for transgender South Carolinians and their allies. For months, transgender individuals and people who have trans loved ones have poured their hearts out in testimony, interviews, and face-to-face with legislators, pleading with them not to pass this harmful bill. They have spoken directly to their personal stories of why access to gender-affirming care is not only medically necessary but vital. They have educated many, even opening the minds and hearts of some who previously never understood the experiences trans folks face. However, that only makes the passage of this bill from the Senate much more devastating. 

In an election year where every member of our general assembly is on the ballot, what we have seen unfold around H4624 has been nothing more than performative politics to pander to an extremist base. Bans on transgender health care are widely unpopular across the political spectrum, as proven by a recent Mason-Dixon poll. Interference in medical decisions is government overreach, pure and simple. For a party that loves to discuss the importance of small government, every time the Republican party strips away medically necessary care (be it abortion or gender-affirming care), they prove the opposite. With just three legislative days left in the legislative session, bills that would positively impact many more South Carolinians lie in wait. At the same time, they continue to push unpopular bills that would harm more than help. 

For a body without a medical doctor in its ranks, what we saw on Thursday, again, were legislators legislating medicine without any understanding of medical practice. Allow me to be frank on two points: 1) gender reassignment surgeries do not take place on anyone under the age of 18 in the state of South Carolina, and 2) gender-affirming care is life-saving care and looks different for everyone. If the intent were truly to ensure surgeries were not happening, that would be the only language needed in the bill. Instead, it goes far beyond, which confirms what we know to be true: attacks on transgender people are the new culture war now that the state has passed its 6-week abortion ban. To ban all medically necessary care for minors strips parents of their freedoms and casts an opportunity for overly-conservative application of the law by medical providers, fearful of going to jail for practicing standard-of-care medicine.

I want to end with a final note of appreciation and love to our trans folks across the state. I know this battle has been extremely hard for you. I want you to know that you are loved, valued, seen, and appreciated exactly as you are. Please know that there are folks across the state who will continue fighting. We are going to continue doing everything we can to support you, guide you, and provide you with the resources you need to thrive.

Title photo: Travis Bell/STATEHOUSE CAROLINA

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